WEDNESDAY, May 22 (HealthDay News) -- Over the next two decades, the cost of treating strokes in the United States is expected to more than double, topping more than $180 billion a year, according to new research.

The main factor driving the increase: an aging population. The report, from the American Heart Association (AHA) and the American Stroke Association, was published May 22 in the journal Stroke.

"Strokes will absolutely strain the health care system," Dr. Bruce Ovbiagele, chairman of the department of neurology at the Medical University of South Carolina, said in an AHA news release.

One expert who reviewed the report agreed.

"The forecasts in this article are indeed dire -- the predicted direct and indirect costs of stroke could place a heavy burden on our society, and they may be underestimates," said Dr. Stanley Truhim, director of the Mount Sinai Stroke Center in New York City.

According to the AHA, the highest uptick in stroke prevalence will be among Americans between 45 and 64 years of age, who will experience about a 5 percent increase in strokes over the next 20 years. Finances will be strained to meet the care needs of these younger stroke victims, who are too young to receive Medicare, less able to afford medications and often suffer from obesity or diabetes.

People who do not have health insurance also have a 24 percent to 56 percent greater risk of death from stroke than those with coverage, according to the AHA statement.

The AHA also predicted the following will occur by 2030:

Overall, nearly 4 percent of U.S. adults -- an additional 3.4 million people -- will have a stroke.

Stroke treatment costs will increase from $71.6 billion in 2010 to $183.1 billion.

Stroke-related costs tied to lost work productivity will rise from $33.7 billion to $56.5 billion.

Stroke prevalence among Hispanic men will increase. Strokes are more prevalent among Hispanics and blacks than whites.

The costs associated with caring for people are often high because an attack can lead to long-term disability, Ovbiagele said. "Ninety percent of stroke patients have residual disability and only 10 percent recover completely after a stroke," he said. "Policy makers at all levels of governance should be aware of this looming crisis so we can consider practical ways to avert it."

According to the AHA, stroke remains the fourth leading cause of death in the United States and one of the most significant causes of preventable disability.

Recognizing a stroke when it happens and getting the patient to medical help quickly are imperative. "During every minute of delayed treatment, brain cells are dying," Ovbiagele said. "[Emergency workers] should take patients directly to a designated stroke center equipped to quickly diagnose and administer drugs to restore blood flow to the brain."

Dr. Richard Libman, vice chairman of neurology at the Cushing Neuroscience Institute in Manhasset, N.Y., called the AHA report "realistic and sobering."

"It emphasizes the importance of stroke prevention -- that is, paying attention to the frequent risk factors plaguing our country, including high blood pressure, smoking, obesity, diabetes and lack of exercise," he said. "It also reminds us that even if we cannot prevent all strokes, continued investment in research to find new treatments and rehabilitation strategies can prevent suffering on the human level and also save billions of dollars in health care costs."

According to the AHA, the Affordable Care Act is expected to expand health care coverage to an additional 32 million Americans. The legislation also is shifting the focus to prevention and wellness. The researchers believe health-care reform should help reduce the number of strokes and deaths as well as stroke-related costs.

Truhim agreed. "It is quite possible that health-care expenditures mandated by [Affordable Care Act] provisions will more than pay for themselves in indirect cost savings when people who otherwise may have had strokes or other debilitating illnesses remain productive members of society," he said.